Healthcare Provider Details
I. General information
NPI: 1649606260
Provider Name (Legal Business Name): COURTNEY ANN HUNEYCUTT CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/16/2013
Last Update Date: 09/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1629 AIRPORT RD STE B
HOT SPRINGS AR
71913
US
IV. Provider business mailing address
1661 AIRPORT RD STE D
HOT SPRINGS AR
71913-8184
US
V. Phone/Fax
- Phone: 501-767-0075
- Fax: 501-760-2739
- Phone: 501-625-7500
- Fax: 501-625-7777
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | A003912 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: